Next meeting will be held on Monday, March 13th, at 7:30pm. Details coming soon.
Drs. Marla Deibler, Rachel Strohl, and Rob Zambrano on our OCD Panel,
"Ask the Experts"
by Dr. Rachel Pess
Marla Diebler, Psy.D
Marla Diebler, Psy.D, is the Vice President of OCD New Jersey, and is a licensed psychologist in New Jersey and Pennsylvania. She is Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia, LLC, an outpatient behavioral health treatment center that specializes in the evidence-based treatment of anxiety and obsessive-compulsive spectrum disorders located in Cherry Hill, New Jersey. Dr. Deibler serves on the Board of Directors of the Trichotillomania Learning Center (TLC) as well as the Faculty of TLC’s Professional Training Institute.
Rachel Strohl, Psy.D
Rachel Strohl, Psy.D, is Secretary on the Board of Directors at OCD New Jersey, and is a New Jersey licensed psychologist. She has been an associate at Stress and Anxiety Services of NJ in East Brunswick for over a decade. She has been certified in the treatment of OCD by the BTTI and BFRBs such as skin picking and compulsive hair pulling by TLC. Dr. Strohl has developed a specialization in the cognitive behavioral treatment of anxiety disorders and OCD Spectrum Disorders, and works with adults, adolescents, and children.
Robert Zambrano, Psy.D.
Robert Zambrano, Psy.D. , is Treasurer on the Board of Directors at OCD New Jersey, and is a New Jersey licensed psychologist. He has been an associate at Stress and Anxiety Services of NJ in East Brunswick for nine years. Dr. Zambrano has been certified in the treatment of OCD by the BTTI and BFRBs by TLC. He specializes in the treatment of anxiety disorders and OCD Spectrum disorders, as well as Tourette Syndrome and related disorders. He works with adults, adolescents, and children.
On December 12, 2016, Drs. Deibler, Strohl, and Zambrano presented as a panel of experts at the quarterly meeting of OCD New Jersey. The audience consisted of professionals in the field, as well as individuals or family members of those suffering from OCD symptoms. Audience members asked a number of relevant and thought-provoking questions to the panel, which led to an informative and stimulating discussion.
Professionals were interested in hearing suggestions related to the differentiation of OCD symptoms from Autism Spectrum Disorder related behaviors, as well as ways to tailor treatment to individuals presenting with this combination of symptoms. The experts discussed the level of difficulty that is inherent in treating cases of that nature, and discussed ways to make the treatment more structured and concrete. For example, the experts suggested eliminating the more abstract metaphors that are common to OCD treatment. Panelists also gave advice to move slowly through treatment, and to be creative in how you present and discuss concepts. In addition, the experts discussed the ways in which they differentiate an obsession from a perseveration. The main distinction is that obsessions lead to distress and feelings of anxiety, while perseverations are enjoyable.
Other questions were posed relating to recent developments and adaptations to OCD treatment based on research. The experts discussed distress tolerance versus habituation during EX/RP, and recent shifts in thinking related to these processes. Panelists explained that historically the goal of EX/RP has been habituation, or decreased symptoms of anxiety. More recently, researchers have found that EX/RP does not always lead to habituation, but rather individuals become more tolerant of distress and discomfort. The experts discussed Tourettic OCD, in which individuals strive for the "just right" feeling versus other forms of OCD, which involve fears related to an aversive consequence. Professionals also sought advice on specific cases.
Additional questions were asked related to ways in which family members can help their loved one transition back into the home following an inpatient hospitalization. The experts discussed challenges related to re-emergences of symptoms following a hospitalization, and not only normalized this experience but offered helpful suggestions for how to manage this in the home. An individual shared that he had a similar experience following an inpatient hospitalization, and discussed how he dealt with it. A family member of an individual suffering with OCD symptoms asked the panelists how to determine whether or not you have the correct therapist, which led to a discussion about the importance of implementing the gold standard, evidence-based treatment for OCD, called Exposure and Response Prevention (EX/RP) therapy. EX/RP therapy consists of developing a hierarchy of feared situations and slowly exposing the individual to these situations, while blocking the associated compulsions. In addition, the experts discussed goodness of fit and the typical course of treatment. This also led to a discussion about how the goal of therapy is to manage OCD rather than "cure" it.
Dr. Rachel Pess
Dr. Rachel Pess is a post-doc fellow at Stress and Anxiety Services of New Jersey, where she works as a clinician under a NJ psychology permit. She works in both the East Brunswick and Springfield offices.